Cranial magnetic resonance imaging findings in methanol poisoning: Systematic review and meta-analysis of radiological prevalence

Purpose This meta-analysis aimed to evaluate the pooled prevalence of key cranial magnetic resonance imaging (MRI) findings in methanol poisoning, including putaminal necrosis, optic nerve injury, and mortality. Objective Methanol intoxication is a potentially fatal condition causing severe neurological deficits, yet the prevalence of MRI-detected brain lesions remains incompletely characterized. Methods A systematic review and meta-analysis were conducted following PRISMA 2020 and Cochrane Handbook guidelines. Studies reporting MRI findings in patients with confirmed methanol poisoning were retrieved from Medline, Scopus, and Web of Science. A random-effects model was used to pool proportions, and heterogeneity was assessed using the I 2 statistic. Results Thirteen studies were included in the systematic review. Of these, eight studies contributed data on putaminal necrosis ( n = 163), four on optic nerve injury ( n = 108), and seven on in-hospital mortality ( n = 154). Patients were predominantly male, aged 17–77 years, with oral ingestion as the main exposure route. Mortality showed a pooled prevalence of 7.8% (95% CI 2.2–24.1; I 2 = 53.9%). Optic nerve injury had a pooled prevalence of 36.1% (95% CI 9.2–75.8; I 2 = 84.0%). Putaminal necrosis was the most frequent MRI finding, with a pooled prevalence of 47.6% (95% CI 30.3–65.6; I 2 = 75.0%). Conclusion MRI abnormalities are highly prevalent in methanol poisoning. Putaminal necrosis is the hallmark radiologic feature, while optic nerve injury affects approximately one-third of cases. These findings support MRI as a key tool for assessing methanol-induced neurotoxicity.